Sleep Apnea Diagnosis and Treatment - Dr. Anil Rama, MD | JawCast #61

Interesting

50k subs? I didn t even know that you crossed 10k 😂 Congrats

Jawhacks we still didn’t discuss , The Epiglottis,

Man I've been going down this route starting as a referral for ADHD-PI. Still waiting for that (waiting list is 1.5 years!). Then I found out about SDB on my own. I have no energy at all, it's messing up my academic performance, I had major allergies during puberty, I had 4 premolars pulled for braces. It's insane to see how common this experience is and yet it has so little recognition.

Please link Jawhacks baby channel?

wow

Thank you Ron for all the great info. I've been following your channel for more than a year now since i got diagnosed with severe sleep apnea at 32 years old(got premolars extracted + this crazy metal bar and band around the neck at night for months and have been snoring hard since teenage). Got mma surgery two weeks ago - recovery is hard but no more snoring + I can hold my tongue at the roof of my mouth. Cheers from France.

This is a great one

Can you be born with a small airway?

Ron, I just wanted to thank you from the bottom of my heart for this and all of the interviews you’ve done.
You ask such profound and insightful questions and I really admire how present and locked in you are. Kudos, my friend. I think the impact you are having on others is not yet fully known but will be one day 🙏

And thank you Dr. Rama for sharing and your vulnerability in talking about your own jaw surgery!

Wow, loved all the new info in this interview! Thanks guys!

Hey Ronald, you should cover more how MSE can exacerbate sleep apnea. One surgeon explained to me that when you open up nasal complex greater pressure occur down the throat and that increase collapsibility of airways, which happened to me. Bernoulli s law, like Dr. Anil mentioned.

dr rama is my sleep dr and he's amazing!

I've truly enjoyed the direction you've taken. Better late than never. Onwards and upwards!

Before I had MSE I did turbinate reduction which helped very little. And now when my expander is removed and all went well, CBCT showed my turbinates filled the space again, but my nasal breathing is better than ever despite that. Very interesting.

Dr.Rama is one of the best, most respected, knowledgeable, intelligent, caring Doctor out there! He is the type of Doctor that ACTUALLY wants to help his patients and see them succeed in their health! He goes above and beyond! This podcast is one of the most informative out there!

Great video. I would like a video where you discuss decompensation of teeth before jaw surgery with a jaw surgeon. Like the pro and cons of extracting teeth like premolars or wisdom teeth to do the dental decompensation.

Very informative podcast ❤

Anyone caught that procedure of getting the inflammation of your turbinates down so they shrink to normal size?
Can someone write down all the sprays he was mentioning and is anyone doing this?
So, if I get it right that's actually something that you need to keep on doing even after all the expansions because allergy doesn't go away from surgery (sadly), right?
Would be happy about some insides because it struck me that I may needed to use way more medication all the time.

so can the brain damage from sleep apnea be reversed? Im going to experiment with psilocybin/lions mane/niacin(stamets stack) microdoses

Ron and Dr. Rama, this is an eye opener. I had never heard of orthosomnia. There is very little about it on google. The OCD cheap made me laugh.

I am currently a patient of Dr. Rama's and can confidently say that he is the GOAT when it comes to this stuff. Yesterday I had my follow-up brain map session to see how the CPAP was working and he was so generous with his time to thoughtfully analyze the results with me (which revealed that my brain is functioning MUCH faster and more efficiently since I started using the CPAP and his protocol). I will be forever grateful to him and his lovely team!

Excellent podcast! Dr. Rama is on the cutting edge of technology and is an amazing doctor who cares deeply for his patients!

I saw Dr Rama for my sleep study before I did EASE and he was very enlightening. Loved this deep dive as well.

Great discussion. A couple of comments from another Stanford Trained Sleep Physician. 1. I don’t need a CBCT in my office because every airway orthodontist I work with has one and I can look at their scans. 2. Most ENTs don’t like RF turbinate reduction because they feel it doesn’t get good results and doesn’t last. And question for Dr. Rama if he has considered pursuing MMA?

so you can't fix the brain injury, ever?

How does the location of an arousal in the brain due to a respiratory event affect the possible symptoms that may occur? Does it affect the possible behavioral symptoms that may be experienced, or can it even affect any physiological symptoms that may occur due to the drop in oxygen level?

Damn i wish there were dr's like dr Rama in the UK. Impossible to find a dr who actually cares and thinks deeply on the whole picture of sleep disordered breathing to get to the root cause. Its an epidemic in the whole of medicine really, all they care about its sticking a band aid on you, fleecing your wallet and kicking you out the door as quickly as possible. Im an engineer and if i fixed machines like these dr's id be out of a job by the end of the month.

A post-outcome survey would be extremely interesting, Ron! I am undergoing EASE and would be willing to participate when I'm done. Likely undergoing MMA eventually as well.

Drug Induced Sleep Endoscopy is helpful in pinpointing the location of the airway obstruction

Talking about babies…I wonder if infants should NOT be placed on their backs. I wonder if sleep position not only affects the airway closing, but the development of the airway. I also wonder that with lying on tummy, as a person gets older maybe they should use specialized positioning on their knees, versus lying flat on stomach. And other positions that could be used.

I’m convinced it’s mostly from narcissistic abuse especially in family. And of course underdevelopment

Great interview!! I'm honestly more confused than ever, the steps going through all of this and still seems left up to the patient to figure out what to do and where to go for help. It's so frustrating

Interesting podcast, I wonder if there’s any brain treatments that can be done in the comfort of my home .

Dr. Rama is my doctor and I have to say he’s the best. Very knowledgeable and more helpful than any other physician with cpap therapy.

It depends where you go to receive care! Dr. Rama can give you a personalized plan that aims to solve sleep issues! You should definitely check him out if no where else is working!

Ron, can we talk more on the tongue base thickening causing airway blockage?

Great interview. I like the analogy that sleep apnea is like traumatic brain injury and each time you wake is like a mini concussion.

Can someone please help me understand what Dr. Rama means when he says aim for aesthetic and the rest is on you? What activities is he referring to? Myofunctional therapy? Staying fit? Both?

Who is the Dr. Li he keeps mentioning?

I love your channel and this interview. Things I’d like to see as segments or separate channels:

1. Jaw Results—including both aesthetic and functional before and after’s (scans, photos and subjective comments about energy, attractiveness, self esteem, quality of life, etc). Hopefully some interviews can include the name of the surgeon or have the surgeon discuss the case.

I’d be interested in hearing about surgeons covered by different health insurances or hearing from good (under the radar) surgeons who aren’t expensive celebrity surgeons.

2. Jaws Botched— including what went wrong and why, the journey of finding surgeons and revision solutions with updated before and afters. Many are dealing with repairing old ortho, extraction or surgeries and this process is also complicated

3. Jaw Options—It was interesting hearing Dr Rama talk about how different surgeons all had different recommendations for the same patient. It would be interesting (to me) to see a surgeon’s round table with them all discussing specific cases. If the patient then selected one of the plans, then later there’d be a before/after followup showing who they picked (like HGTV House Hunters for jaws).

4. I’d watch a “Where Are They Now” segment of past patients and what the surgery did for them including life changes, scans and photos. Would they do it again? What would they change?

So MSE can make the airway worse? Greeeaaaaat